Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Department of Psychology, University of Maryland, College Park, MD, USA.
Eur Child Adolesc Psychiatry. 2023 Dec;32(12):2491-2501. doi: 10.1007/s00787-022-02093-5. Epub 2022 Oct 10.
Depression in early childhood increases risk of psychopathology and impairment across the lifespan. Parent-Child Interaction Therapy-Emotion Development (PCIT-ED) effectively treats depression and improves functioning in preschoolers. Parental depression has been associated with inconsistent parenting, depression onset and maintenance in offspring, and decreased treatment efficacy for youth. Given the intensity of parent involvement in PCIT-ED, this secondary data analysis aimed to evaluate parental depression severity (i.e., Beck Depression Inventory-II Total Score; BDI-II) as a moderator and predictor of child, parenting, and engagement outcomes, within the context of a randomized trial. Children (N = 229; ages 3-6.11) with early childhood depression and a consenting caregiver were randomly assigned to receive PCIT-ED or Waitlist (WL). Moderation results supported the superiority of PCIT-ED over WL on child and parenting outcomes, independent of parent-reported BDI-II at baseline (p ≥ 0.684 and p ≥ 0.476, respectively). BDI-II did not significantly predict child (p ≥ 0.836), parenting (p ≥ 0.114) or engagement (p ≥ 0.114) outcomes. Finally, BDI-II did not surpass chance in predicting whether children would maintain a depression diagnosis after PCIT-ED (AUC = 0.530) or prematurely terminate treatment (AUC = 0.545). Our results suggest that PCIT-ED is not contraindicated by minimal-to-moderate symptoms of depression in parents. Taken together with previous reports, PCIT-ED may indeed be a particularly beneficial treatment choice for this population. Further research in samples with more severe parental depression is needed. ClinicalTrials.gov identifier: NCT02076425.
儿童早期的抑郁会增加整个生命周期中心理病理学和功能障碍的风险。亲子互动治疗-情绪发展（PCIT-ED）有效地治疗了幼儿的抑郁，并改善了他们的功能。父母的抑郁与不一致的育儿方式、后代的抑郁发作和维持以及青少年治疗效果的降低有关。鉴于 PCIT-ED 中父母的参与度很高，这项二次数据分析旨在评估父母抑郁严重程度（即贝克抑郁量表第二版总分；BDI-II）作为一个调节者和预测者，在一项随机试验中评估儿童、育儿和参与结果。患有儿童早期抑郁并同意参与的照顾者的儿童（N=229；年龄 3-6.11 岁）被随机分配接受 PCIT-ED 或候补名单（WL）。调节结果支持 PCIT-ED 在儿童和育儿结果方面优于 WL，而与父母报告的基线 BDI-II 无关（分别为 p≥0.684 和 p≥0.476）。BDI-II 对儿童（p≥0.836）、育儿（p≥0.114）或参与（p≥0.114）结果均无显著预测作用。最后，BDI-II 并没有在预测儿童在接受 PCIT-ED 后是否会保持抑郁诊断（AUC=0.530）或提前终止治疗（AUC=0.545）方面超过机会水平。我们的结果表明，PCIT-ED 对父母轻度至中度抑郁症状没有禁忌症。结合之前的报告，PCIT-ED 可能确实是该人群的一种特别有益的治疗选择。需要在有更严重父母抑郁的样本中进行进一步的研究。临床试验标识符：NCT02076425。
